New Client Form

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New Client Form

Pet information #1

We want to learn all about your pet!

Financial Policy Acknowledgement

We thank you for entrusting us with the care of your pet.  In order to provide the best possible animal care, we require that all professional fees be due at the time of service. We accept cash and credit cards including Visa, MasterCard, American Express, and Discover.  We also accept Care Credit.  


WE REQUIRE IMMEDIATE PAYMENT FOR SERVICES RENDERED OR MEDICATION PRESCRIPTIONS FULFILLED ON SITE.  


I hereby authorize the doctor and technicians to administer services and treatment as explained to me by the doctor.  I assume all financial responsibility for all charges incurred for the care and treatment of my pet(s).  I understand that services are to be paid for when rendered.  


At my request, I will receive a written estimate for services beyond routine care, which I may decline for any reason.

Schedule Policy Acknowledgement

At Charm City Veterinary Hospital, your scheduled appointment time is reserved exclusively for you and your pet.  Charm City does not overbook appointment times. We believe optimal veterinary care can be provided only if we have enough time set aside to adequately examine and diagnose your pet, then discuss treatment options in detail with you.


We will make every effort to accommodate your scheduling needs.  In return, we ask that you help us by keeping your scheduled appointments by arriving on time.  If a situation arises that you will be late or not able to attend your appointment please let us know ASAP.  When Charm City Vet receives advanced notice of cancellations, we are able to accommodate other patients needing care.  Failure to comply with this policy will necessitate the assessment of the following fees:


You will receive an email stating that you missed an appointment and that you have been charged a Missed Appointment Fee ($60.00).   In addition, when making future appointments the office visit fee must be paid at the time you schedule the appointment.

Late Arrival Policy

Appointments involving clients arriving more than ten minutes late may be considered "Missed Appointments" and may need to be rescheduled.  If you think you are going to be late for your appointment, please call us to determine if your late arrival can be accommodated or if you will need to reschedule.


ALL ABOVE FEES WILL BE ASSESSED PER PET IN CASES OF MULTIPLE PET APPOINTMENTS.

Additional Comments

Please use the space below to share any additional information about your pet(s) you deem applicable. Thanks!!!